Unlawful NHS restraint

Unlawful NHS restraint

…But is all as it seems?

Staff at an NHS Trust in the Midlands have been accused of unlawfully restraining patients, including a 14 year old child. The allegations are thought to have been made by the Trust’s former head of security, but the claims are denied by Trust Chief Executive Paula Clark.

The news article doesn’t give specifics with regard to any particular incidents where patients may have been unlawfully restrained, however does state that the information has been passed to the Care Quality Commission (CQC) for further investigation.

The use of restraint on patients, particularly children and vulnerable adults is a very emotive and controversial subject. The concern and worry for staff and managers has been compounded by previous investigations such as the Winterbourne View Inquiry in 2011, the release of the Pindown Report in 1991 and countless other investigations into excessive and inappropriate levels of force and dreadful ‘techniques’ used in care facilities across the UK.

As a result many care staff, including security personnel are unsure of when they can, or more appropriately should physically intervene and what level of force they should use in any given scenario. This confusion can lead to hesitation or even unwillingness to act when a situation may require physical intervention, in turn potentially causing unnecessary pain, injury and suffering to staff as well as patients and service users.

So how can we remedy this? How can we ensure staff are aware of exactly where they stand in relation to the use of reasonable force and the law? More importantly, will this prevent further incidents of unnecessary injury to staff and service users?

Well the good news is that this can be remedied. Through fit for purpose and legally accurate NHS restraint training, guidance and supervision we can stem the tide of people getting hurt in the workplace. Moreover, we can confidently defend our actions if challenged by those unaware of the legalities in relation to restraint and the use of force. Suitable training will enable this in two ways. Fit for purpose techniques and legally accurate education.

Techniques employed by staff need to fit three main criteria:

• Effective
• Easy to recall
• Safe

The techniques need to be effective. There is no point being taught techniques that either don’t work or only work in prescribed situations. Staff need to be taught techniques that will work regardless of age, gender or build.
The techniques must be easy to recall, particularly in high stress situations when a chemical change occurs in our bodies. Adrenaline is just one of the numerous chemicals that floods our bodies when involved in high stress scenarios and as a result our thought processes become more instinctual and our fine motor skills are greatly reduced. Techniques that involve multiple steps and small movements are easily forgotten when they are needed the most. By making the techniques simple and easy to recall we are ensuring they will be used, reducing the possibility of reverting back to pre-learnt, instinctive techniques such as head locks and neck holds.

All techniques must be safe to apply. Restraint is a tool used to prevent a greater harm from occurring, not as a punishment and as such techniques that are likely to cause injury or death should never be taught. In particular, any techniques or positions that restrict breathing or the movement of the chest cavity should not be used.

Providing staff with legally accurate education in relation to the law and guidance regarding restraint and the use of reasonable force, will undoubtedly increase their confidence when managing violent situations and incidents of restraint. This in turn will lead to a reduced number of staff and service users being injured and an increase in restraint incidents being resolved more efficiently and professionally.

Furthermore it will eradicate any confusion over whether it was unlawful to restrain a 14 year old child or not. As it is suggested ‘Forewarned is forearmed’.

For further advice on this subject, get in touch with the team at COVIC Training Solutions.